Bharti AXA Life marked its entry into health insurance by launching a triple benefit critical illness plan recently. The plan, Triple Health Insurance Plan, allows you to claim three times, and each time, the sum assured is 100 per cent.
This is its USP, since other critical illness policies allow only one claim. Here, the customer stops paying premiums after the first, and is still allowed to make two more.
The Triple Health plan covers 13 critical illnesses and is at par with most health insurers who cover eight-12 ailments on an average. Typically, the higher the number of ailments covered, the better. Yet, customers need to read the fine print regarding conditions attached to the coverage. In this plan, the list of illnesses has been classified into three groups. A claim can only be made for one illness from each group. So, if a customer has made claim for a heart attack, which belongs to group A, he will not be covered for a coronary artery bypass or heart transplant that fall in that category. Besides, there has to be a mandated gap of at least one year between each of the claims.
There are other deterrents, too. While the maximum entry age at 50 and the renewal ceasing age at 65 is at par with what most other policies offer, the Triple Health plan has a fixed 15-year tenure. The fixed tenure will not favour younger policyholders, say insurance experts. "Usually, even a 30-year old person buying a policy is assured of having it renewed till age 65. But, here, the 30-year old will not be renewed after age 45,"says Abhishek Bondia of Secure Now Insurance Brokers.
Such persons will be at a disadvantage while buying a new policy, since insurers charge higher premiums for those in the higher-age bracket.
Thanks to the three-claim benefit, one also ends up paying more premium for the plan. So, a 35-year male will pay Rs 3,360 for a sum assured of Rs 5 lakh. Premiums charged by other general health insurers work out much cheaper. HDFC ERGO's critical illness cover costs Rs 1,654, Bharti Axa General Insurance's costs Rs 1,314, while Bajaj Allianz General Insurance's costs Rs 1,654. However, these come with single-cover option only.
The plan also has a 'premium return' facility that can be availed at a higher premium of Rs 7,665. Customers are eligible for a maturity benefit in the absence of claims, getting back an amount equal to 15 times the first year's premium.
In case of death, the nominee will be paid a sum equal to the first-year premium multiplied by the number of years the policy existed. But this, according to Pankaaj Maalde, head, financial planning, apnapaisa.com, restricts the death benefit. "Why not opt for a term plan, which, for Rs 10 lakh sum assured, costs just Rs 2,000? It will pay out the full sum assured, instead of just the first-year premiums."
But, if you are keen on buying the plan, insurance experts suggest buying just the basic premium plan, besides your regular indemnity-based mediclaim policy. Critical illness plans make a one-time payment on diagnosis of the illness, while mediclaim policies pay the actual expenses incurred for treatment (subject to the sum assured). A critical illness plan cannot substitute the basic health cover offered by an indemnity plan and, hence, should be bought as an additional cover. One-time payouts should be used to take care of other expenses, besides those incurred due to hospitalisation.
